Comparing performance among male and female candidates in sex-specific clinical knowledge in the MRCGP

Abstract

Background: Patients often seek doctors of the same sex, particularly for sex-specific complaints and also because of a perception that doctors have greater knowledge of complaints relating to their own sex. Few studies have investigated differences in knowledge by sex of candidate on sex-specific questions inmedical examinations. Aim: The aim was to compare the performance of males and females in sex-specific questions in a 200-item computer-based applied knowledge test for licensing UK GPs. Design and setting: A cross-sectional design using routinely collected performance and demographic data from the first three versions of the Applied Knowledge Test, MRCGP, UK. Method: Questions were classified as female specific, male specific, or sex neutral. The performance of males and females was analysed using multiple analysis of covariance after adjusting for sex-neutral score and demographic confounders. Results: Data were included from 3627 candidates. After adjusting for sex-neutral score, age, time since qualification, year of speciality training, ethnicity, and country of primary medical qualification, there were differences in performance in sex-specific questions. Males performed worse than females on female-specific questions (-4.2%, 95%confidence interval [CI] = -5.7 to -2.6) but did not perform significantly better than females on male-specific questions (0.3%, 95%CI = -2.6 to 3.2%. Conclusion: There was evidence of better performance by females in female-specific questions but this was small relative to the size of the test. Differential performance of males and females in sex-specific questions in a licensing examination may have implications for vocational and post-qualification general practice training. ©British Journal of General Practice.